Individual
CANDACE S BOHANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1289 E LIVINGSTON AVE, COLUMBUS, OH 43205-2838
(614) 252-8834
Mailing address
5000 CARBONDALE DR, COLUMBUS, OH 43232-4559
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C.1600612
OH
374U00000X
Home Health Aide
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0147236
—
OH
Enumeration date
12/10/2015
Last updated
11/17/2017
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